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Indigenous Community Health andClimate Change: Integrating Biophysicaland Social Science IndicatorsJamie Donatutoa, Eric E. Grossmanb, John Konovskyc, SarahGrossmana & Larry W. Campbellaa Office of Planning, Swinomish Indian Tribal Community, La Conner,Washington, USAb U.S. Geological Survey, Pacific Coastal and Marine Science Center/Western Fisheries Research Center, Seattle, Washington, USAc Tsleil-Waututh First Nation, North Vancouver, British Columbia,CanadaPublished online: 27 Jun 2014.

To cite this article: Jamie Donatuto, Eric E. Grossman, John Konovsky, Sarah Grossman & Larry W.Campbell (2014) Indigenous Community Health and Climate Change: Integrating Biophysical and SocialScience Indicators, Coastal Management, 42:4, 355-373, DOI: 10.1080/08920753.2014.923140

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Coastal Management, 42:355–373, 2014Published with license by Taylor & FrancisISSN: 0892-0753 print / 1521-0421 onlineDOI: 10.1080/08920753.2014.923140

Indigenous Community Health and ClimateChange: Integrating Biophysical and Social

Science Indicators

JAMIE DONATUTO,1 ERIC E. GROSSMAN,2

JOHN KONOVSKY,3 SARAH GROSSMAN,1

AND LARRY W. CAMPBELL1

1Office of Planning, Swinomish Indian Tribal Community, La Conner,Washington, USA2U.S. Geological Survey, Pacific Coastal and Marine Science Center/WesternFisheries Research Center, Seattle, Washington, USA3Tsleil-Waututh First Nation, North Vancouver, British Columbia, Canada

This article describes a pilot study evaluating the sensitivity of Indigenous communityhealth to climate change impacts on Salish Sea shorelines (Washington State, UnitedStates and British Columbia, Canada). Current climate change assessments omit keycommunity health concerns, which are vital to successful adaptation plans, particularlyfor Indigenous communities. Descriptive scaling techniques, employed in facilitatedworkshops with two Indigenous communities, tested the efficacy of ranking six keyindicators of community health in relation to projected impacts to shellfish habitat andshoreline archaeological sites stemming from changes in the biophysical environment.Findings demonstrate that: when shellfish habitat and archaeological resources areimpacted, so is Indigenous community health; not all community health indicators areequally impacted; and, the community health indicators of highest concern are notnecessarily the same indicators most likely to be impacted. Based on the findings andfeedback from community participants, exploratory trials were successful; Indigenous-specific health indicators may be useful to Indigenous communities who are assessingclimate change sensitivities and creating adaptation plans.

Keywords climate change, community health, impact assessment, Indigenous,sea-level rise, shellfish, shoreline armoring

Introduction

Several parallel efforts among U.S. and Canadian Indigenous1 communities and federal,provincial, state, academic, and non-profit organizations are underway to identify and assessspecies, habitat, and human health and wellbeing sensitivities to climate change at localand landscape scales (cf., Carlson 2012; Dalton, Mote, and Snover 2013; Snover et al.

© Swinomish Indian Tribal CommunityAddress correspondence to Jamie Donatuto, PhD, Environmental Health Analyst, Swinomish

Indian Tribal Community, Office of Planning, 11430 Moorage Way, La Conner, WA 98257, USA.E-mail: jdonatuto@swinomish.nsn.us

Color versions of one or more of the figures in the article can be found online atwww.tandfonline.com/ucmg.

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2013; Swinomish Indian Tribal Community [Swinomish] 2009; Turner and Clifton 2009).The project described herein cross-walks biophysical and social science by employing aset of recently developed Indigenous community health indicators (IHIs) to identify coastalclimate adaptation priorities for Coast Salish communities. The indicators’ efficacy is testedin two Indigenous communities by evaluating community health2 impacts and prioritiesbased on projected climate change effects to shorelines, shellfish habitat, and archaeologicalresources in the Salish Sea region.

The project aims to test the efficacy of the IHIs in each community to determinewhether: (1) the IHIs resonate with community members by accurately depicting non-physical aspects of Indigenous community health and (2) they illustrate how Indigenouscommunity health is affected, and to what degree, when coastal climate change altersIndigenous foods, habitats, and archaeological resources. Myriad potential uses exist if trialsof the IHI tool prove successful; most germane to this project is the use of IHIs to informclimate change adaption planning and decision-making for recovering natural biophysicalprocesses that sustain aquatic natural resources and enhance community resilience.

The Swinomish Indian Tribal Community (Swinomish) in Washington State, led thework presented here, in collaboration with the Tsleil-Waututh First Nation in BritishColumbia, and the U.S. Geological Survey’s Pacific Coastal and Marine Science Cen-ter and Western Fisheries Research Center. Partners provided expertise in climate scenariomodeling and indicator sensitivity assessments for the physical shoreline, shellfish habitat,archaeological resources, and Indigenous community health.

Like many forays integrating social and biophysical sciences, this project requiredcareful negotiation among researchers to ensure equitable input from all disciplines inthe basic approach, methods, data analyses, and discussion of outcomes. Strang (2009)lays out foundational guidelines for interdisciplinary collaborations such as those followedfor this project. This article intersperses paragraphs describing biophysical methods, re-sults, and outcomes (i.e., the environmental indicators) with sociocultural methods, results,and outcomes (i.e., the IHIs), and relies heavily on Indigenous knowledge. While thefocus is on development and implementation of the social science aspects, both socialand biophysical sciences are necessary for the design, implementation, and outcomes ofthis project.

Background

The World Health Organization (WHO) defines health as, “a state of complete physical,mental and social well-being and not merely the absence of disease or infirmity” (WHO1946) that is “a positive concept emphasizing social and personal resources as well asphysical capabilities” (WHO 1998). Many Indigenous peoples define health and wellbeingsimilarly, including familial and community-wide considerations, reflecting interlinked so-cial, cultural, spiritual, environmental and psychological aspects of health. Such Indigenoushealth systems are complex, structured in content and internal logic, and comprise practicesand knowledge about connections between human beings, nature, and spiritual beings (cf.,Arquette et al. 2002; Harris and Harper 2000; Turner et al. 2008).

How health is defined and assessed is a high priority for Indigenous communities,who are confronted with considerable health risks from impacts to homelands and beyond.Climate change is one of the largest-scale and potentially most devastating threats to thehealth and wellbeing of Indigenous peoples (Nakashima et al. 2012; United Nations 2009;USEPA 2012). Emerging health assessments focus on either: (1) individual, physiologi-cal health outcomes, which neglect community-scale, social, cultural, and mental health

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Indigenous Health Indicators 357

aspects; or (2) defining community health metrics qualitatively, which is beneficial to thecommunity, yet difficult to replicate in other communities or at a geographically larger scale.Few Indigenous health evaluations are applicable beyond a localized area (two are: NewZealand’s Whanau Ora Health Impact Assessment (New Zealand Ministry of Health 2007)and the First Nations Regional Longitudinal Health Survey in Canada (2005)), and veryfew evaluations integrate cultural priorities with natural resource management decision-making (one is the Maori Cultural Opportunity Mapping and Assessment (Tipa and Nelson2008)). Although these frameworks represent crucial steps forward, no systematic methodof evaluating and prioritizing climate driven-risks and impacts to Indigenous communitiesbased on Indigenous health definitions exists. Such a method would more efficiently andeffectively confront and plan for climate-related issues in Indigenous communities.

Climate change impacts to aquatic habitats and species have the “potential for signifi-cant impacts on subsistence fishing Tribes” (USEPA 2012, 18). Salmon, clams, and otherspecies that rely on the shoreline during one or more life phases are examples of “firstfoods”—an integral part of an extensive network of Coast Salish values, beliefs, and prac-tices (Garibaldi and Turner 2004). Additionally, archeological resources, also referred to ascultural properties, are of cultural and spiritual importance to the Coast Salish (cf., Stappand Burney 2002). Many archaeological resource sites are located along shorelines and areat risk due to climate change. When these first foods, supporting habitats, or archaeologicalsites are impaired, the resultant amplification of negative effects reverberates throughoutthe social, cultural, mental, and physical aspects of Coast Salish life (Donatuto, Satterfield,and Gregory 2011; Turner et al. 2008).

For example, archaeological surveys along Burrard Inlet (British Columbia) shorelinehave identified village sites, short-term camps, shell middens, pictographs, fish weirs, andclam gardens. The shoreline and beaches near the Tsleil-Waututh Indian Reserve havealways been considered a “home” for Tsleil-Waututh community members, much like ahouse is to modern families. It is here that the community cares for their ancestors. Gath-ering and storytelling are frequent activities helping elders and youth connect. Communityresidents have expressed a feeling of disheartenment due to cultural losses as the shorelinechanges.

Future scenarios of sea-level rise are summarized from West US Coast Sea LevelRise Assessment (National Academy of Sciences [NAS] 2012), which provides estimatesfor Washington’s outer coast. Future sea-level rise projections for the Salish Sea remainuncertain due to complex vertical land motions (Mote et al. 2008) but are likely to be higherthan the NAS projections due to land subsidence and reversal of recent depressed ratesof west coast sea-level rise that appear to change with decadal-scale variations in regionalwind stress (Bromirski et al. 2011). Recent measurements of global sea-level rise follow themaximum rise rate predictions of the 2007 IPCC and are accelerating (Church and White2011), which suggests a likelihood of higher future sea levels than predicted.

Coastal Indigenous communities are disproportionally vulnerable to climate changeand sea-level rise because many reserves reside in vulnerable coastal lowlands (Hanna1997). Assuming conservative estimates of sea-level rise, an estimated 1,100 acres of theSwinomish Reservation, or approximately 15% of Reservation land, are potentially at riskof inundation from increasing sea-level rise (Swinomish 2009). On the Tsleil-WaututhIndian Reserve and nearby, nearly 75% of 311 acres of intertidal zone and 3 miles of steepshoreline are at risk.

Shoreline armoring is commonly employed to protect upland coastal property fromerosion and inundation. In Puget Sound, it is estimated that one third of the shorelines arearmored by seawalls, bulkheads, rip rap, and other materials (Berry 2000). Armoring is

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effective in protecting upland property, but ultimately deprives beaches of sediment andbulk wood delivery. When beaches lose local upland inputs, the chronic forces of tides,currents, and wind waves erode beaches in front of armored shorelines (Shipman 2010).As sea levels rise around Puget Sound, erosion due to shoreline armoring will intensify,expediting the loss of nearshore habitats, beach access and connectivity for recreationalpurposes.

In 2007, the Swinomish Indian Senate signed a proclamation directing action to studythe possible effects of climate change on the Swinomish community, lands, resources,and tribal community health, and to determine appropriate responses. The Swinomish Im-pact Assessment Technical Report (Swinomish 2009) and Swinomish Climate AdaptationAction Plan (Swinomish 2010) evaluated a broad range of risks and potential adaptationstrategies for the Reservation’s lands and infrastructure. The reports have been widely cir-culated and used as a model template in tribal climate change adaptation strategies (e.g.,University of Oregon 2013). These vanguard reports contain placeholders for areas ofstudy that had yet to be explored; those pertinent to this study are shoreline impacts andIndigenous community health and wellbeing.

While most agree on the importance of considering the multi-faceted relations be-tween humans and the environment (cf., Millennium Ecosystem Assessment 2005), thelack of an established methodology to do so often results in assessments omitting keyaspects, or worse, violating beliefs and values (Satterfield et al. 2013; Turner et al. 2008). In2004, authors Donatuto (Swinomish staff) and Campbell (Swinomish elder and staff) be-gan interviewing Swinomish community members, researching ethnographic records, andstudying health evaluation methods to develop health indicators reflective of the Tribe’snon-physical definition of health (Donatuto, Satterfield, and Gregory 2011). Donatuto andCampbell then partnered with other Coast Salish Tribes to create an indicator set re-flective of Coast Salish community health. Researchers identified six Indigenous HealthIndicators (IHIs): Community Connection, Natural Resources Security, Cultural Use, Ed-ucation, Self Determination, and Well-being (Figure 1) (Donatuto, Gregory, and CampbellIn review).

The IHIs may be beneficial for a variety of assessments (e.g., use in health impactassessments, natural resource damage assessments, human health risk assessments, andclimate change impact assessments). Swinomish chose to focus on climate change due toconcurrent work on the Swinomish Climate Action Initiative.

Methods

The methods are described by project task below and illustrated in the project’s logic model(Figure 2).

Task 1: Finalize Project Collaborations

Formalizing a partnership between two sovereign nations requires a clear and explicitmemorandum of understanding that details the purpose of the project, data collectionmethods, access to the data, review and approval of the data, and dissemination approaches.3

For this project, both communities agreed that each community retained sole ownershipover its own data, and that data would not be used in project analyses or released withoutprior review and approval by that community’s leadership. Fostering such collaborationstakes time and patience, and a clear understanding of each community’s decision-makingprocesses and protocols.

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Indigenous Health Indicators 359

Community Connection: Members actively participate in community functions and

help each other, particularly in connection with the harvest, preparation, and

storage of natural resources.

Natural Resources Security: Local natural resources (air, water, land, plants and

animals) are abundant, accessible and support a healthy ecosystem(s) and healthy

human community. The community equitably shares these natural resources.

Cultural Use: The community is able to perform their cultural traditions in a

respectful and ful�illing way using the local natural resources.

Education: Knowledge, values and beliefs are actively passed from elders to youth.

Self Determination: Communities develop and enact their own healing,

development and restoration programs.

Well-being: Community members maintain connections to meaningful locations,

con�ident that their health and the health of the next seven generations are not at

risk due to contaminated natural resources.

Figure 1. Indigenous Health Indicators (Donatuto, Gregory, and Campbell In review).

Task 2: Compile Existing Data on Chosen Environmental Indicatorsfor the Two Project Communities

The U.S. Environmental Protection Agency and Environment Canada have identified anumber of environmental indicators to evaluate the health and trends of the transboundarySalish Sea water body (Puget Sound Partnership 2012; USEPA 2013). Evaluating the statusof environmental indicators is a first step toward prioritizing management and restorationactions to improve Salish Sea health. For this project, Swinomish and Tsleil-Waututheach selected two environmental indicators, inventoried available data relating to thoseindicators, and created projections of the status of those indicators relative to climatechange. Criteria for indicator use included: (1) applicable to lands within reservation/reserveboundaries; (2) indicators appropriate for the Swinomish and Tsleil-Waututh communities;and (3) sufficient existing data supporting the indicator.

Swinomish selected shellfish beds and shoreline armoring as indicators. Swinomish hasan established shellfish and nearshore monitoring program with nearly two decades of dataon shellfish density, species composition, and shorelines profiles for several Reservationbeaches.

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Figure 2. Logic model for “Correlation and Climate Sensitivity of Human Health and EnvironmentalIndicators in the Salish Sea” project.

Tsleil-Waututh selected shellfish beds and shoreline archaeological resources as indi-cators. The Nation has an objective of re-establishing traditional shellfish harvests that havebeen closed by water and sediment pollution for at least 40 years. Monitoring is ongoing andrestoration plans are under development, but there is concern that sea-level rise will limitfuture opportunities and threaten to undermine numerous shoreline archeological sites.

The case study area for the Swinomish portion of the project was Lone Tree Point, oneof the most valued and highly utilized shellfish areas on the Swinomish Reservation, locatedon the western shore (Figure 3). This study area was selected because of the availabilityof extensive shellfish monitoring data and a current digital elevation model, essential forgenerating maps of current status and future change. Frequent Tribal access for culturaland economic activities helped engage community members in the workshop.

Tsleil-Waututh studied the shoreline and intertidal area extending from MaplewoodFlats to Cates Park on the north shore of Burrard Inlet just east of Second Narrows.Burrard Indian Reserve No. 3 is located along this stretch of shoreline and a majorityof Tsleil-Waututh community members live here. The area once served as a tremen-dous source of natural resources as documented in the many archaeological sites lo-cated there. Like Swinomish, site significance helped generate interest in workshopparticipation.

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Figure 3. Results from the analysis of current (2012, yellow) and predicted 2100 (red) har-vestable shellfish area and shoreline armoring (blue) at the Lone Tree Point–Swinomish Reservationstudy site.

Researchers synthesized digital datasets representing shellfish biomass, sediment char-acteristics, beach elevation, and shoreline armoring from existing sources to model climatechange impacts to the chosen environmental indicators in each community (Table 1).Datasets were compiled into an Environmental Systems Research Institute geographic in-formation systems (GIS) database and plotted using ArcGIS 10.1. Although the datasetsrepresent the best available science with the highest level of resolution for the study area,maps, and results presented in this report were generated to provide a tool that characterizesrelative differences in impacts and do not claim to predict actual impacts nor the responseto all possible forcing parameters.

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Table 1Swinomish environmental indicator data sources (shellfish habitat and beach armoring)

Dataset Source Provides

Shellfish: 2011 S.gigantean and L.staminea biomass andlocation data

Swinomish FisheriesDepartment

Polygons which providethe basis for the possiblerange of harvestableshellfish

1996 1:24,000 SedimentCharacteristics

Washington State Departmentof Natural Resources,Aquatic ResourcesDivision, Shoreline HabitatProgram

Polygon and line coverageof intertidal shorelinecharacteristics

Shoreline armoring Swinomish PlanningDepartment

Line data representingman-made structuresalong the SwinomishReservation shoreline

2011 Orthorectified coloraerial photography

USDA-FSA AerialPhotography Field Office

Aerial photography of thestudy site

Digital Elevation Model U.S. Geological Survey High resolution elevationdata for the study site

Two shellfish species, butter clams (Saxidomus gigantean) and native littlenecks(Leukoma staminea), referred to here as shellfish, were chosen because they are, or were,the primary shellfish species harvested by Swinomish and Tsleil-Waututh for commer-cial, recreational, ceremonial, and subsistence uses. The shellfish habitat examined extendsfrom subtidal depths to roughly 1.5 meters above Mean Low Lower Water (MLLW) inareas with mixed cobble, gravel, and finer sediment particles and commonly with bro-ken shell. For analytical purposes, the lower elevation band of harvest area was set tothe 0.3 meter elevation contour below MLLW, the level of extreme summer low tidesat the study site. The upper elevation band of harvest area was set to 1.5 meters aboveMLLW.

At Swinomish, using a high-resolution Digital Elevation Model (Grossman and HorneIn review), polygons were generated for the potential shellfish harvest areas along LoneTree Point in ArcGIS using these upper and lower shellfish habitat bands. The shellfishharvest areas were refined further using the 1996 Washington State Department of NaturalResources, Aquatic Habitat Division, Shoreline Habitat Program’s substrate polygons,removing areas of the beach where substrate types are unsuitable for shellfish habitat (suchas bedrock). Shellfish biomass polygons from 2011 (Barber et al. 2012) were used todelineate and validate the newly generated polygons.

Researchers generated future shellfish harvest area polygons by taking the methodologydescribed above and projecting the upper and lower shellfish contours higher on the beachface based on projected sea-level rise of 1.29 meters for the Salish Sea by 2100 (Mote et al.2008; National Academy of Sciences 2012; Vermeer and Rahmstorf 2009). This value foryear 2100 sea-level position is consistent with global rates of sea-level rise (Bindoff et al.2007) and with vertical land movements (subsidence) within the Salish Sea (Mote et al.2008) and the mid-value of Vermeer and Rahmstorf (2009).

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Project staff calculated shellfish harvest area from these projections, the change reflect-ing variations in area along shore due to beach morphology. The projected elevation bandsalso highlight areas where beach migration is limited due to shoreline armoring. Armoringin the Lone Tree Point study area includes 178 meters of rip-rap protecting the southernportion of Lone Tree Point, and 950 meters of bulkhead protecting property on the northernportion. Due to limited availability of multiple data layers akin to the Swinomish data, asimilar, simpler exercise was completed at Tsleil-Waututh to define current shellfish habitatas well as projected habitat in 2100. Additional layers of archeological site polygons wereadded to the Tsleil-Waututh maps to show current location and projected inundation in2100 from sea-level rise.

Task 3: Compile Community Health Data in the Context of the IHIs and ChosenEnvironmental Indicators

Each community analyzed how community health, as presented in the IHIs, may be con-nected to the chosen environmental indicators. This task was primarily a literature reviewcombined with ground-truthing via interviews with community knowledge holders (fordefining who is an expert, see: Davis and Wagner 2003). Literature review sources includedcommunity reports (e.g., Annual Reports, historic atlas), publications by government agen-cies (e.g., Health Canada, USEPA), and academic papers. At Swinomish, much of thisinformation had been gathered during the creation of the IHIs; the list provided a templateof source types and locations for Tsleil-Waututh.

Project staff evaluated each IHI in the context of current community health data, currentenvironmental indicator data, and how community members might define and assess eachIHI. The outcomes were descriptions that were unique to each community but still alignedwith the overall IHI set. For example, at Swinomish the indicator that referred to gatheringsand ceremonies and the reciprocal respect between people and natural resources is calledCultural Use. At Tsleil-Waututh, this indicator was termed Cultural and Spiritual Practices.Naming the health indicator in terms most used by community members avoids confusionas to what the indicator represents and, ultimately, respects how each community definesand talks about health.

Task 4: Pilot Testing the IHIs in the Context of Climate Change Facilitated Workshops

Each community hosted one workshop to test the IHIs in the context of shoreline envi-ronmental responses to climate change. Because this project was exploratory in nature,demographic representation was not necessary; staff personally invited 10–20 experts andelders to attend the workshop (Table 2). Researchers presented the workshop in PowerPoint,and participants answered questions using wireless, handheld polling devices. Responseswere calculated using TurningPoint software, and summary results were immediately shownon the screen. Individuals’ answers remained anonymous. Workshops were structured asfollows: (1) collect demographic data; (2) evaluate and rank the current health status in thecommunity using the IHIs; (3) discuss maps and data of projected climate change impactsto: shoreline armoring (at Swinomish), shellfish habitat (Swinomish and Tsleil-Waututh),and archaeological resources (Tsleil-Waututh); (4) evaluate and rank projected status ofthe IHIs in the future, based on projected climate change-driven impacts; and (5) assesspriority concerns of the IHIs in the context of the projected climate change impacts.

Workshop participants used a constructed scale to evaluate the IHIs in parts 2 and 4 ofthe workshop. A constructed scale is a simple descriptive index (e.g., a Likert scale). Scales

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Table 2Workshop demographics

Swinomish Tsleil-Waututh

Workshop participant # 16 8Female 12 3Male 4 5Ages: 21–40 6 241–60 5 361+ 5 3

translate qualitative information into quantitative scores, without losing the informationassociated with the score, and without sharing proprietary information. Oral histories,scientific information, maps, and other images can be associated with a specific rating on ascale (Keeney and Gregory 2005; Gregory et al. 2012). Indigenous communities employingdescriptive ranking techniques to assess priorities is not a new idea (e.g., McDaniels andTrousdale 2005). The scale used in the workshops corresponded with a statement abouthealth status: “1—very bad,” “2—not very good,” “3—pretty good,” and “4—great.”4

Part 5 of the workshop used pair-wise comparisons for weighting the indicators (vonWinterfeldt and Edwards 1986). Weighting is necessary to elucidate each indicator’s relativeimportance. Not all of the indicators may have equal importance to the participants; knowingwhich indicators are the highest priorities benefits planning and decision-making. Basedon pre-tests, participants found pair-wise comparisons the easiest weighting method tounderstand and complete (compared to swing weighting5). The weighting exercise enabledparticipants to prioritize the indicators of highest concern and the indicators most likely tobe impaired (noting that these prioritizations may not be the same). A lower prioritizationwould not mean that the indicator is less important, only that it requires less immediateattention, due to greater resiliency or adaptive capacity to the specific climate changeimpacts presented.

The trial run of the IHIs would be considered successful if: (1) the participants felt thatthe indicators accurately reflected key aspects of community health; (2) the indicators wereuseful in thinking about impacts to health based on a specific context (in this case, climatechange); and (3) the participants were comfortable with the ranking and weighting exercises.

Task 5: Community Health Impact Assessment

Results from parts 2, 4, and 5 of the workshop questions were used to generate an ex-perimental impact assessment of the IHIs. Due to the exploratory nature of the projectand small data sets, project researchers utilized simple avenues for experimenting withcreating impact assessment metrics that aligned with the metrics used in the SwinomishImpact Assessment Technical Report (2009) and Climate Change Adaptation Action Plan(2010). The Swinomish reports employed a four-point descriptive scale of “low, medium,medium-high, high” in rating impact sensitivity (exposure/susceptibility), probability ofimpact, estimated risk, potential priority, and adaptive capacity for coastal and upland re-sources, physical health, and community infrastructure and services. A scale mirroring theSwinomish reports was used with an additional positive (non-negative impact) measure of“potential opportunity” to address indicators ranked as healthier in the future compared to

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today. Project researchers calculated the projected impacts for each indicator by comparingthe total percent of answers ranked by participants with a 1 or 2 for the current health statusto the total percent of answers ranked 1 or 2 for the projected future health. The result wasa percent change, positive or negative, between the current and future health status of eachindicator. Indicators with a positive percent change were rated as a “potential opportunity.”Indicators with a 25% or less decrease in health were ranked as “low.”6 Indicators with a26% to 50% decrease in health were given a ranking of “medium.” Indicators in the rangeof 51% to 75% were labeled “medium-high,” and indicators above 76% were considered“high” on the impact ranking scale. Part 5, weighting the indicators, allowed project re-searchers to compare the “most highly impacted” indicator results to the indicators rankedas “highest priorities,” thus providing opportunities for focusing climate change planningefforts.

Results and Discussion

The analyses of environmental indicators focused on examining likely impacts of climatechange on tribal shellfish and archeological resources. While sophisticated numerical mod-els are required to forecast changes in shoreline morphology, this project used a simpleestimate of projected sea-level rise inundation to test the utility of integrating environmentalindicators with community health indicators.

Based on the mapping exercise, Lone Tree Point currently has 11.0 hectares of har-vestable shellfish area situated across a low-sloping “low tide terrace” and a relatively steepmid and upper beach face. With a projected sea-level rise of 1.29 meters by 2100, the lowestextent of the harvest band across the low-tide terrace will become subtidal and inaccessible,and the upper harvest band will migrate landward where (lack of) armoring allows. Shellfishbeds could be reduced to 8.0 hectares by the change in inundation alone by the year 2100,a 27% reduction driven primarily by inundation and loss of the large low-tide terrace areacommonly accessed today (Figure 3). This is likely an underestimate of impacts to shellfishand harvest area, as armoring can enhance scour that leads to substrate coarsening (Krausand McDougal 1996), which indirectly increases the resuspension of fine sediment, bothof which are unfavorable for shellfish.

At Tsleil-Waututh, the analyses of environmental indicators examined the impacts ofclimate change on community shellfish resources and archeological sites. The same caveatsfor the Swinomish analyses of environmental indicators apply. The results show a loss of75% of current intertidal shellfish habitat, and damage to the majority of the archeologicalsites along the shoreline.

Shoreline morphology, shellfish habitat, and community adaptation decisions willbe influenced by a complex interaction of sea-level rise, storms surge, waves and otherclimate change drivers. The influence diagram (Figure 4) provides an initial framework forcharacterizing and modeling drivers and outcomes of environmental and social processes. Italso serves as a Bayesian and scenario-based modeling framework. This framework can beused to examine likely outcomes of scenarios as well as quantify the influence of uncertaintyin individual drivers. Defining uncertainty helps to inform next steps in model refinement,data collection, and community needs. For example, a decision to maintain or removeshoreline armoring can be examined using IHIs to evaluate the community’s prioritiesgiven tradeoffs between preserving coastal protection infrastructure or maintaining viableshellfish harvest area. Other biophysical processes affecting shellfish habitat and access toharvest due to projected changes in wave energy and shellfish substrate linked to runoff and

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Figure 4. Simplified influence diagram illustrating driver-response linkages between environmentaland social (decision) processes affecting shellfish harvest area and identified Indigenous HealthIndicators to inform coastal planning. Processes addressed in this study (shaded in grey) will berefined with analyses of additional climate change and ocean acidification drivers in the next phasesof the study.

sediment delivery are recommended for subsequent research to refine the shellfish harvestarea projection results explored here.

Discussing the projected changes to the shoreline using maps as visual aids madestrong impressions on the community members present at both workshops. Participantinterest in the information sparked numerous conversations, at times bringing up suggestionsfor specific adaptation actions. Discourse between the project team and the communitymembers was positive yet poignant—community members felt health would be affectedby coastal climate change impacts, but remained hopeful about viable options to explorethrough the adaptation planning process.

The pilot project met all of the criteria to be considered a success. Participants felt theindicators accurately reflected key aspects of community health and were useful in thinkingabout health impacts from climate change. Participants were also comfortable completingthe ranking and weighting exercises.

At the Swinomish workshop (results in Figure 5), participants ranked Cultural Useas most impacted in 2100, followed by Natural Resources Security, Self Determination,and Community Connection. As one community member explained, “Recognizing theindicators and talking about them is a way to start to deal with them. These things, impactsto our way of life, are way down deep and you maybe cannot see it, but it weighs on your

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Projected Impacts: Low → High

Potential opportunity

(+ % ∆)

Low (O to –25% ∆)

Medium (–26 to –50%

∆)

Medium-high(–51% to –75%

∆)

High (> –75% ∆)

Priority concerns:

Low↓

High

CC CU

ED WB SD

NRS

∆ = change; results are not representative of the community; results are for discussion purposes only

NRS = Natural Resources Security CU = Cultural UseED = Education CC = Community ConnectionSD = Self Determination WB = Well-Being

Figure 5. Swinomish community health sensitivity matrix.

whole spirituality; you get fatigued, spiritually worn out.” Participants emphasized that inthe context of climate change and relative to other community health indicators, concernfor Cultural Use was low. The group anticipated that Cultural Use would be less sensitiveto harm from climate change. As one Swinomish participant said, “we don’t worry asmuch about culture for this, it will always be with us.” However, beyond climate changeconcerns, the group remained very concerned about the state of Cultural Use and its impacton community health in general.

Community members were most concerned about projected climate change impacts toNatural Resources Security, followed by Self Determination, Well-being, and Education.Although Education was rated fairly high as a concern, community members ranked thehealth status of this indicator as improving in the future. One participant’s comment pro-vided insight: “Climate change is changing our resources. We are horrified, but the moreyou learn, the more you learn you can do something.” This highlights that the workshopitself can be considered an educational opportunity as well.

At the Tsleil-Waututh workshop (results in Figure 6), participants ranked NaturalResources Security as the indicator most impacted in the future. The highest concernswere for Natural Resources Security and Well-being. Climate change–induced reduction ofeveryday beach use and associated damage to archaeological sites weakens Tsleil-Waututhcommunity health, as it disrupts Tsleil-Waututh members’ connections to their ancestors,a foundation/cornerstone of their cultural responsibility. The group ranked the Well-beinghealth status as improving in the future (with the caveat that Well-being is not less of aconcern in general). Education was ranked both as improving in the future and as a lowconcern in the context of the climate change projections. Participants stressed that Educationis a top priority for the Nation and they remain concerned about the state of education andits impact on community health. The Tsleil-Waututh participants were positive about theirhealth projections overall: Education, Community Connection and Cultural Use (calledCultural and Spiritual Practices at Tsleil-Waututh) were all ranked as improving in the

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Projected Impacts: Low → High

Potential opportunity

(+ % ∆)

Low (O to –25% ∆)

Medium (–26 to –50%

∆)

Medium-high(–51% to –75%

∆)

High vulnerability

(>–75% ∆)

Priority concerns:

Low↓

High

ED SD

CC, CSP

WB NRS

∆ = change; results are not representative of the community; results are for discussion purposes only.

NRS = Natural Resources Security CSP = Cultural and Spiritual Practices (Cultural Use at Swinomish)ED = Education CC = Community ConnectionSD = Self Determination WB = Well-Being

Figure 6. Tsleil-Waututh community health sensitivity matrix.

future (Figure 6). In future workshops, additional questions probing why people projectedthe health status of indicators to improve or decline will be included.

The style of the workshop—centered on a PowerPoint and using polling devicesthat collated numerical ranking data—limited the IHI exploratory trials in the ability toevaluate non-scripted discussions that arose (i.e., why participants felt that a particularhealth indicator would improve or decline over time). Weighting the IHIs was also alimitation. Although weighting is important in prioritizing and making choices, none of theweighting techniques proved ideal. In pre-trials, swing weighting proved more cognitivelydifficult than choosing between two options (paired comparisons). In order for the pairedcomparisons to work, however, all participants must complete the entire paired-comparisonweighting exercise. If one or more participants decided not to answer one or more pairedcomparison questions, it was not possible to complete the calculations or a validity test inorder to assess whether people answered in a logical and meaningful way. Yet, as part ofthe workshop process, no participant is required to answer all of the questions; it is strictlyvoluntary. Methods for incorporating information from discussions and the use of otherweighting methods will be considered in future IHI workshops.

This project did not attempt to make comparisons between the two communities. Eachcommunity, even neighboring communities, is unique. Comparing differences betweencommunities will not aid in evaluating the efficacy of the IHIs. The purpose of piloting theworkshops in each community was to test whether the IHIs would reflect a community’sparticular concerns and priorities, so project researchers anticipated the results would notbe the same in each community and that assumption was confirmed.

For researchers interested in working with Indigenous communities to enact similarstudies, numerous sets of ethical research guidelines for community-based research ex-ist (e.g., community-based participatory research [CBPR]; cf., Israel et al., 2005). Whilethe subjects of respecting Indigenous knowledge and the complexities of evaluating suchknowledge alongside western science are discussed extensively elsewhere (cf., Nadasdy2003; Menzies 2006; Simonds and Christopher 2013), it can never be stated enough that In-digenous communities themselves have sovereignty over use of Indigenous knowledge and

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engagement practices. Given the negative historical and cultural consequences of re-searchers outside of Indigenous communities leading assessments, this is a criticaljuncture—facing tangible global climate change impacts—wherein the communities’ as-sertion of control must be respected and heeded.7

When Indigenous-based valuations such as the IHIs are employed in conjunction withenvironmental indicators, the complex linkages between community health and wellbeingand the economic and ecologic costs and benefits common to vulnerability assessmentsare more equitably promoted. Regionally, results may help moderate challenges faced bydecision-makers and affected communities who often fail to communicate effectively inthe absence of a common language about risks and impacts. As one participant stated,in some regards, lack of specific policy and regulations on both sides of the border aboutdefining and assessing Indigenous health, or even social indicators more generally, providesan opportunity to introduce a tool such as the IHIs that is supported by communities andemploys a common language.

The results of IHI development and testing may help to inform policies that promotecoastal property development setbacks, buy-outs, or land swaps in order to accommo-date long-term community health and ecosystem function as well as hazard mitigation.For Swinomish, the next steps will continue to integrate the biophysical and social sci-ences. Swinomish plans to initiate a project to assess the vulnerability of Swinomish firstfoods, coastal ecosystem habitats, and culturally significant sites in relation to sea-levelrise, storm surge, and shoreline development. A representative sample of Swinomish com-munity members will evaluate the results of these detailed assessments using the IHIs.Outcomes will inform gaps in the Swinomish Climate Change Adaption Action Plan(2010), which will in turn support coastal zone planning and decision-making on theReservation.

In British Columbia, First Nations must take the lead on climate change adaptationand planning in an overall effort to address Indigenous community health. Both provin-cial (Carlson 2012) and local (HB Lanarc Consultants 2010) governments are developingstrategies to address climate change. Carlson identifies “loss of cultural or historical siteson the coastline” as an impact to climate change, but does not go on to address any adap-tation strategies specifically for this impact. Neither of these efforts attempts to addressconcerns unique to Indigenous communities like Tsleil-Waututh. Federal funds have beenallocated through the Climate Change Adaptation Program within the Aboriginal Affairsand Northern Development Canada for First Nations to begin the process, but these fundsare limited and allocated to the communities deemed most vulnerable to climate impacts.A systematic method such as the IHIs may help multiple First Nations begin their climatechange assessment and adaptation planning in concert. While results will be unique to studyparticipants, Indigenous communities along the Pacific coast are facing similar impendingthreats of climate change and the need to create adaptive land-use policies; the methodsdeveloped through this project are meant to be adapted and applied by other First Nationsand Tribes across the region.

Acknowledgments

This article has been peer reviewed and approved for publication consistent with USGS Fun-damental Science Practices (http://pubs.usgs.gov/circ/1367/). Many thanks to the workshopparticipants for sharing their views, and to Andrea Woodward, Sarah Fox, and peer review-ers for insightful comments on earlier drafts.

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Funding

Research was funded by awards to the Swinomish Tribe from the North Pacific LandscapeConservation Cooperative and the NW Climate Science Center (#F12AP0094) and the U.S.EPA National Center for Environmental Research (#RD-83479101). The content is solelythe responsibility of the authors and does not represent the official views of the SwinomishIndian Tribal Community, the Tsleil-Waututh First Nation, or the funding agencies.

Notes

1. “Indigenous peoples and nations are those which, having a historical continuity with pre-invasion and pre-colonial societies that developed on their territories, consider themselves distinctfrom other sectors of the societies now prevailing on those territories, or parts of them. They format present non-dominant sectors of society and are determined to preserve, develop and transmit tofuture generations their ancestral territories, and their ethnic identity, as the basis of their continuedexistence as peoples, in accordance with their own cultural patterns, social institutions and legalsystem.” Martınez Cobo (1987) in United Nations (2009).

2. Community health is defined here as the non-physical aspects of health on the scale ofextended family, Tribe, or First Nation.

3. For guidance on developing and enacting culturally appropriate data and material sharingagreements with Indigenous communities, see Harding et al. (2012).

4. In pretests, community members preferred to use a “forced choice” four point scale so thatthere is no neutral “middle road” option (Allen and Seaman 2007).

5. Swing weighting asks participants to imagine a change in each indicator from its worst tobest levels, comparing the amount of benefit derived from the swing of the bottom indicator to thebenefit derived from the swing of the top indicator (i.e., a ratio comparison), then to quantify thebenefit as a percentage of the “swing value” of the top indicator.

6. A change in health of 10% or 15% could be considered much more than a “low” impact; thismethod would necessitate much more detailed scaling and ranking analyses if employed in actualassessments.

7. See Williams and Hardison (2013) for a more comprehensive discussion of Indigenous knowl-edge, climate change, and the “cultural, legal, risk-benefit and governance contexts of knowledgeexchange.”

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